Doctor Assisted Suicide

Suicide is the act or instance of taking one’s own life voluntarily and intentionally especially if that person is of sound mind. Euthanasia is the act or practice of killing individuals who are hopelessly sick or injured for reasons of mercy. Doctor-assisted suicide is a term used to describe the act of a doctor or physician providing direct or indirect means of assisting someone in taking their own life. There are 2 types of euthanasia. Passive euthanasia is withholding life-sustaining treatment either before or after it has been initiated. Active euthanasia is “taking steps to end your life, as in suicide, handling the action yourself” (Humphry 20). It is an explicit act such as writing a lethal prescription or a directly injecting a lethal dose. Approximately 30,000 Americans kill themselves every year.

This means that the rate of suicide is about 11.0 per 100,000 people. This rate is just the average, and it varies greatly among sexes and races. The suicide rate for males is 19.8, but the rate for females is 3.8. This difference in rates appears deceptive because females are 3 times more likely to attempt suicide than males. Males are just more effective in their methods. White Americans have a higher rate of suicide than any other ethnic group. It is believed that homosexuals have a much greater rate than heterosexuals, but this is difficult to research because many homosexuals hide their sexual orientation from fear of persecution. The terminally ill are most closely associated with the doctor-assisted suicide issue. Many in this group argue that once all medical care has failed, then one has the right to hasten death to avoid pain and suffering. If a person is going to inevitably die from a painful disease, then that person should have the right to decide when, where, and how death comes.

There are many ways for one to commit suicide. The 2 major types are self-inflicted and assisted. Despite the popular issue of legalizing doctor-assisted suicide, most suicides remain self-inflicted. Zeinert describes the statistics:

According to the National Center for Health Statistics (NCHS), the majority of those who commit suicide do so by shooting themselves. In fact, the latest statistics available from the NCHS show that 59 percent of all suicides were committed with some kind of firearm. Firearms can be found in more than half of all American households. (55)

Two other popular methods are suffocation and ingestion of poison or pills. Pills are not very effective because the adequate dose varies for different drugs. Taking pills also allows the person time to change their mind and vomit the pills before absorption. Other methods are jumping from high altitudes such as bridges or cliffs, drowning, crashing an automobile, or slashing the veins in a wrist. These methods are frequently attempted but do not have a high success rate. Assisted suicide is usually accomplished by a family member or physician providing the adequate means for committing suicide. This is very common with persons who do not have the ability to commit suicide on their own.

Many ancient cultures embraced and accepted suicide. In Greece suicide was considered acceptable if one’s health failed or when faced with scandal or shame. If a person was able to convince authorities that his or her death was warranted, then a lethal dose of the poison called hemlock was prescribed. The modern day Hemlock Society, the largest right to die society, was named after this poison. The Christian church did not even legislate against suicide until the sixth century because of the persistence of Saint Augustine. He was appalled by the high number of suicides and urged the bishops to establish a law against it. He based his argument from the sixth commandment of thou shalt not kill, but most of his ideas came from Plato’s Phaedo. This was his reasoning:

And because each soul is immortal, every life is valuable. Since life itself is a gift from God, to reject it is to reject him and to frustrate his will; to kill his image is to kill him-which means a one-way ticket to eternal damnation. (Uhlmann 61)

The actual mentions of suicides in the Bible were not recorded as being wrong or being crimes against God. If intent is argued, then it can be said that even Jesus Christ committed a type of suicide. According to the Bible he was sent down to sacrifice his life for others.

Some recent court cases have changed laws and some attitudes towards doctor-assisted suicide. Two cases reached the United States Supreme Court in January 1997 and were decided simultaneously on June 26, 1997. The two cases were Washington State versus Glucksberg and Vacco versus Quill of New York State. The ruling in both cases backed the two state statutes which banned doctor-assisted suicide for the terminally ill. Linda Greenhouse wrote that the Supreme Court’s tone was that of a tentative first step rather than a definitive final ruling on the issue (1). In an ACLU news release called “High Court Rejects Constitutional right to Doctor-Assisted Suicide”, the ACLU’s national legal director argued:

Each of us should have the right to die in a humane and dignified manner. The exercise of this right is as central to personal autonomy and bodily integrity as rights safeguarded by this Court’s decisions relating to marriage, family relationships, procreation, contraception, child rearing and the refusal or termination of life-saving medical treatment. (1)

On October 27, 1997 doctor-assisted suicide became a legal medical option for terminally ill Oregon residents. This made Oregon the first State in the Union to pass such a measure. Voters in Oregon passed the “Death with Dignity Act” by only a 60% majority, and the measure remains very controversial among residents of Oregon. On November 28, 2000 the Dutch Parliament passed a bill to authorize doctors in certain situations the right to assist someone wishing to take their life. Dutch doctors have not been severely punished over the last 30 years for assisting in suicide, but this measure makes it clearly legal in certain circumstances.

The right to die argument remains a very controversial topic in the United States. If a woman has the right to choose when an unborn baby is killed, then should not everyone have the right to decide when he or she dies? This is especially important when terminal illness or irreversible pain and suffering is involved. A person of sound mind is perfectly capable of making the decision of committing suicide when the time is right. Doctors and scientists are the ones who have altered the course of mankind’s natural life expectancy.

Pharmaceutical companies have made trillions of dollars on the elderly by inventing new and more potent chemicals to keep the body from expiring. Modern medicine does not extend life; it only prolongs death. It seems as if the medical community has single-handedly made the choice that people are to be kept alive for as long as possible. If doctors can make a decision to place a person on life-sustaining equipment, then it seems reasonable that an individual should have the right to decide when to die.

In 1990 the United States Supreme Court ruled in the case of Cruzan versus Missouri Department of Health that an individual had the right to avoid unwanted medical treatment to include life-sustaining treatment. In that same year Doctor Jack Kevorkian, a self-proclaimed crusader of the doctor-assisted suicide debate, helped a 54-year-old woman with Alzheimer’s disease to commit suicide. He connected the carbon monoxide emitting exhaust to enter the inside of a van to kill her. He later developed a suicide machine which used a series of injections to help his patients commit suicide. Jack Kevorkian received positive as well as negative attention. He began to receive some negative attention as he claimed to have helped more and more individuals end their lives:

Besides questioning Kevorkian’s standards for acceptance, prosecutors questioned his methods as well. When rumors surfaced that one of his patients tried to change his mind at the last minute but was not allowed to do so, authorities took an even closer look at the doctor’s activities. Eventually they decided that they had enough evidence to arrest and try him. (Zeinert 85)

Kevorkian has been tried 5 times. He was tried the first 4 times for illegally assisting suicide. In all 4 cases family members of the patients were allowed to testify in favor of Kevorkian. He was tried for murder in the last case, and the judge ruled that the family’s testimony was not relevant to the case. Kevorkian unsuccessfully defended himself and was convicted of second degree murder in March of 1999. Many call him a doctor of mercy, and some label him Doctor Death. The opinions on the actions of Kevorkian remain as divided as the issue he represents. He provided a recognizable face which people still associate today. He also provided more controversy for this issue than anyone else. Doctor Kevorkian “undoubtedly performed a notable public service by forcing the medical profession to re-think its attitude on euthanasia” (Humphry 140).

Doctor-assisted suicide is required for those who are going to commit suicide and desire a more humane and dignified method. Self-inflicted suicide is usually gruesome and usually comes unexpectedly to family and friends. The self-inflicted method is too often ineffective. Killing oneself is difficult when the proper tools or knowledge is not correctly implemented. It frequently causes severe injury or paralysis which almost guarantees that the person has no other opportunity to attempt suicide. Doctor-assisted suicide allows for more planning and a preset adjustment period for family members to cope with the loss of a loved one.

Doctors are able to analyze a patient’s mental and physical health before determining whether suicide is an available option. It is important that the proper authorities be sure that the patient is of sound mind and judgment. Independent psychiatric evaluations are also available to ensure that no mistakes are made. If suicide has become the final option for a patient, then organized and legal methods should be in place to assist those who need it. Adam Cohen stated in a Time Magazine article that polls suggest that up to 75% of Americans back mercy killing, even though most state efforts to make it legal have not succeeded (2).

Doctors are taught that human life is to be saved at all costs. It is no surprise that most doctors are opposed to legalizing doctor-assisted suicide. One article states a portion of the American Medical Association’s policy statement on physician-assisted suicide:

It is critical that the medical profession redouble its efforts to eensure that dying patients are provided optimal treatment for their pain and other discomfort. The use of more aggressive comfort care measures, including greater reliance on hospice care, can alleviate the physical and emotional suffering that dying patients experience. (Katz 1)

Doctor’s believe that they are to save lives instead of helping to end them. They argue that doctor-assisted suicide is an oxymoron. If a doctor’s sole purpose is to save lives, then how can they be expected to assist individuals in killing themselves? Perhaps it is time that doctors realize that people wish to be treated like human beings instead of lab experiments. It is impossible to save every person. It is impossible to cure every disease in time. Many terminally ill patients have accepted these facts and just wish to die a peaceful death. Society acknowledges that doctors do in fact save lives. Modern medicine has positively changed the quality of life for everyone in the United States, but sometimes losses are to be cut. Most terminally ill patients rarely see the outside of a hospital and are constantly being pumped with powerful medication and/or radiation. This is no way to live.

Opponents of assisted suicide argue that better hospice care and stronger pain relievers are the alternatives to suicide. They argue that it is unacceptable because it is immoral. However, it seems difficult for someone who has not been directly faced with or affected by this issue to have a valid opinion. The bottom line is that individuals who are in this situation absolutely have the right to decide their own fate. It is hypocritical to believe that individuals have the legal right to choose life or death for an unborn child yet not for their own life.

Why is legalizing doctor-assisted suicide so important? Suicide throughout all societies is imminent. It is especially guaranteed to occur in high rates among those who are facing a slow and painful death. Special considerations are necessary for this group of people. Self-inflicted suicide is neither practical nor humane; doctor-assisted suicide is. This group of people deserves that right when modern science and medicine has failed in its efforts. Any individual faced with inevitable death deserves the right to decide the time and place. If doctor-assisted suicide were made legal, then the government could monitor applications for assisted suicide and regulate the number of doctors performing the assistance. Over 400 years before the time of Christ, Sophocles stated that death is not the worst fear, but rather when we wish to die and cannot (Torr 12).